From the Research
The Blessed Inventory of Mental Status (BIMS) score ranges from 0 to 15, with higher scores indicating better cognitive function, and can be used to assess capacity, with a score of 13-15 indicating intact cognition and capacity to make decisions, 8-12 suggesting moderate cognitive impairment where capacity may be questionable, and 0-7 indicating severe cognitive impairment and likely incapacity to make complex decisions. However, it's essential to understand that BIMS is primarily a screening tool for cognitive impairment rather than a definitive assessment of decision-making capacity 1. Capacity is decision-specific and requires evaluation of a person's ability to understand relevant information, appreciate their situation, reason about options, and communicate a choice. Even individuals with low BIMS scores may retain capacity for simple decisions, while those with high scores might lack capacity for complex ones. A comprehensive capacity assessment should include clinical interviews, functional assessments, and consideration of the specific decision at hand, rather than relying solely on BIMS scores. Some studies have focused on the development and validation of new assessment instruments, such as the Scores of Independence for Neurologic and Geriatric Rehabilitation (SINGER) 1, while others have examined the reliability and validity of existing tools like the modified Barthel Index 2, 3, 4, 5. These studies highlight the importance of using standardized and validated tools to assess activities of daily living and cognitive function, but do not directly address the BIMS score ranges for capacity versus incapacity. Therefore, the BIMS score ranges should be used as a guide, but not as the sole determinant of capacity, and a comprehensive assessment should be conducted to determine an individual's decision-making capacity.